Preventing (Pathology) Resident Physician Burnout

Fellow residents, do you sometimes feel burned out, especially with the dismal winter weather than many of us have been experiencing lately? There have been many, predominantly small sample size, cross-sectional studies over the years on this topic. Methodological deficiencies in many of these studies may bring into question some of the generalized conclusions that they assert but does not discredit the truth that resident burnout exists and should be taken seriously by training programs.

In 2004, an article in JAMA on this topic defined “burnout” as a “pathological syndrome in which emotional depletion and maladaptive detachment develop in response to prolonged occupational stress.”1 Multiple studies have identified factors such as time demands, variability in faculty expectations, work overload that inhibits learning, systemic program issues, inadequate elective time, and lack of communication and support from faculty and peers as potent contributors to resident burnout.1,3 Furthermore,a subsequent study identified that burnout was associated with absenteeism, low job satisfaction, and medical errors.2

So, first, how can we identify if we are experiencing burnout? As with everything in life, know thyself. Conduct an honest self-assessment of your strengths and weaknesses as well as your absolute needs, both at work and outside of it. If you are not good at honestly evaluating yourself, then ask a trusted person who has your best interests at heart their opinion and truly listen. Then set aside designated time to recharge your batteries. For some this means exercise, for others, it may mean spiritual or community volunteer experiences, or even, just doing “nothing.” The key is to not do any residency work during this time. This is often easier said than done but the first step is to make a commitment to try to do so.

Next, be proactive to bring out the change you want to see. Often when we feel that a situation is out of our control or that we have no choice but to submit to a situation that makes us unhappy, fatigued, or emotionally drained, these negative feelings we internalize may manifest as burnout. So, find a way to take back some control. Frequently, part of this does mean cutting out those aspects of your life that have become toxic, whether it be negative situations or negative people. Of course, this is also easier said than done. If I had the cure for this, I’d bottle it and sell it.

Finally, find support. This statement can mean interacting with a mentor who will both personally and professionally “be in your corner” and help guide you through acquiring the necessary skills you need to be a good doctor. It also means to turn to those positive people in your life, whether it is a family member or a good friend, who will listen to you without judgment, let you vent, encourage you in healthy pursuits, but most importantly, remain honest with you and not just be your cheerleader.

Interestingly, a small survey study in 2013 by Medscape of pathologists showed that only 32% of respondents stated that they were burned out.4 Even though the methodology for this study is not stated to be able to determine the legitimacy of this study, it at least gives me hope that if I survive residency, there is hope at the end of the tunnel for a reprieve from those often seemingly, hydra-like tentacles of burnout that threaten to bring us down.